3-1 Gonadal Functions testes

testicle function (2)

sperm production, testosterone production

Male puberty signs

testicular enlargement from rising Luteinizing Hormone and Follicle Stimulating Hormone

Spermatogonia

sperm stemcell

sertoli cells

Nourish sperm cells during spermatogenesis. activated by FSH

Testosterone producing gland

testes 95% adrenal gland 5%

Luteinizing hormone effect on testes

stimulate testosterone production

Follicle stimulating hormone effect on testes

stimulate sertoli cell and spermatogenesis

hypothalamic-pituitary-testicular axis

Gonadotropin releasing hormone-LH,FSH-testostrone

hypothalamic-pituitary-testicular axis negative feedback

testosterone elevation inhibit GnRH, LH, FSH

testosterone function

development and maintenance of secondary male sex characteristics

Virilization

development of male secondary sex characteristics in females from elevated levels of androgens

hyperandrogenemia

adult male: no symptom

prepubertal male: precocious puberty

female children: virillization

Hypergonadotropic hypogonadoism

Primary Gonadal Insufficiency. Low testosterone, elevated FSH, LH, GnRH

Klinefelter’s Syndrome

Hypergonadotropic hypogonadoism
Extra chromosome 47, XXY

Sterile, azoospermia (no sperm in ejaculate)

Androgen Insensitivity Syndrome

Hypergonadotropic hypogonadosim

mutation in androgen receptor gene

female physical phenotype but 46, XY

Infertile

Other causes of Hypergonadotropic hypogonadosim

Mumps, TB, chlamydia, gonorrhea, chemo

Hypogonadotropic Hypogonadism

Secondary or tertiary gonadal insufficiency. Low testosterone, LH, FSH, GnRH

Hypogonadotropic Hypogonadism cause

type 2 diabetes, age, pituitary disease, opioid use, obstructive sleep apnea

Kallmann’s syndrome

X linked recessive trait of impaired GnRH secretion

semen analysis

pH, motility, count, morphology, viability. Analyze within 30 min!!!

Testosterone Replacement Therapy

treatment for hypogonadism. Monitor with prostate specific antigen (PSA) in case of prostate cancer